ORIGINAL RESEARCH article
Front. Digit. Health
Sec. Digital Mental Health
Volume 7 - 2025 | doi: 10.3389/fdgth.2025.1576135
This article is part of the Research TopicConversational Artificial Intelligence Application in Advancing Mental Health and Well-Being for Older AdultsView all articles
Exploring User Characteristics, Motives and Expectations and Therapeutic Alliance in the Mental Health Conversational AI Clare®: A Baseline Study
Provisionally accepted
- 1Charité University Medicine Berlin, Berlin, Germany
- 2Alexianer St. Joseph Hospital, Berlin, Baden-Württemberg, Germany
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This study examined the characteristics, motives, expectations, and attitudes of users interested in AI self-help provided by the bot Clare®, a conversational AI for mental health support, and explored the development of a working alliance. A crosssectional survey of 527 English-speaking self-referred users revealed high levels of anxiety (69%), depression (59%), severe stress (32%), and loneliness (86%). Participants expressed positive attitudes toward digital mental health solutions, with key motives including avoiding embarrassment (36%) and concerns about appearance in face-to-face consultations (35%). Expectations focused on emotional support (35%) and expressing feelings (32%). A strong working alliance was established within 3-5 days (WAI-SR, M = 3.76, SD = .72). These findings highlight the potential of conversational AI in providing accessible, stigma-free support informing the design of human-centric AI in mental health.Future research should explore long-term user outcomes and clinical LLM integration with traditional mental health services.
Keywords: Conversational Artificial Intelligence (CAI), clinical LLM, AI therapy, working alliance, bot
Received: 13 Feb 2025; Accepted: 19 May 2025.
Copyright: © 2025 Schäfer, Krause and Köhler. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lea Maria Schäfer, Charité University Medicine Berlin, Berlin, Germany
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